Provider Demographics
NPI:1740755099
Name:MORRIS, SANDRA ANN (MA-CCC)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:ANN
Last Name:MORRIS
Suffix:
Gender:F
Credentials:MA-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5301 EAST HURON RIVER DRIVE
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48106-0955
Mailing Address - Country:US
Mailing Address - Phone:734-712-2424
Mailing Address - Fax:734-712-5056
Practice Address - Street 1:5301 EAST HURON RIVER DRIVE
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48106-0955
Practice Address - Country:US
Practice Address - Phone:734-712-2424
Practice Address - Fax:734-712-5056
Is Sole Proprietor?:No
Enumeration Date:2018-10-12
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101002371235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist